MED SURGE EXAM | 8th EDITION QUESTIONS WITH ANSWERS 2026
A+PASS ASSURED
Chapter 13: Delirium and Dementia
MULTIPLE CHOICE
1. The family of a patient with Alzheimer disease asks the nurse, “When will my mother
quit being so confused?” On what information regarding dementia should the nurse base
a response?
a. It is a short-term confusional state
that is typically reversible.
b. It is a state of confusion caused
primarily by medications.
c. It is a state of confusion that
usually begins abruptly and lasts a
short period.
d. It is a syndrome that is chronic and
irreversible.
ANS: D
Alzheimer disease is a type of dementia that is chronic and irreversible. Delirium is a
short-term confusional state that has a sudden onset and is typically reversible.
DIF: Cognitive Level: Knowledge REF: p. 205 OBJ: 2
TOP: Dementia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Basic Care and Comfort
2. A nurse is admitting a patient who has been diagnosed as having confusion. What is the
most important observation that the nurse should make regarding this patient?
a. Eating, drinking, and sleeping
patterns
b. Behavior, orientation, memory,
and sleeping habits
c. Urinary and bowel elimination
habits
d. Talking, walking, and sleeping
patterns
ANS: B
The first step in assessing a confusional state is to observe the patient’s behavior,
orientation, memory, and sleeping habits.
DIF: Cognitive Level: Comprehension REF: p. 206 OBJ: 6
TOP: Confusion Assessment KEY: Nursing Process Step: Assessment
, MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
3. While a nurse is dressing a patient who has dementia as a result of Huntington disease,
the patient states, “I don’t want to wear clothes today” and begins to resist help putting
on
, her clothes. What is the nurse’s most appropriate action?
a. Tell the patient that she must wear
clothes or she cannot see her
family later.
b. Get another nurse to help her force
the patient to get dressed.
c. Talk to the patient about her
family coming this afternoon and
continue to assist the patient gently
with dressing.
d. Let the patient go without clothes
but make her stay in her room.
ANS: C
When patients with dementia resist activities such as bathing or dressing, avoiding
confrontations and diverting their attention elsewhere are best.
DIF: Cognitive Level: Application REF: p. 211 OBJ: 6
TOP: Resisting Care KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
4. What are the adaptations to interventions that the Cognitive Developmental Approach
(CDA) to caring for patients with dementia designed to achieve?
a. Increase cognitive abilities.
b. Adapt environment to patient.
c. Offer a wide variety of choices.
d. Abolish irrational fears.
ANS: B
The CDA adapts implementations based on the patient’s cognitive abilities as they are,
modifies the environment, and offers limited choices.
DIF: Cognitive Level: Knowledge REF: p. 211 OBJ: 6
TOP: Cognitive Developmental Approach
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
5. A nurse is gathering information from the family of a patient who is
experiencing confusion. What important question should the nurse ask the
family?
a. “Are you sure she is confused?
Maybe she just didn’t hear what
you were saying.”
b. “When did you first think she
might be confused? Tell me
exactly what happened.”
c. “Did something bad happen to her
during her childhood?”
, d. “How can you say she is
confused? She knows who she is.”
ANS: B
Family members may be able to provide helpful information when the patient cannot.
The nurse should ask when the symptoms of confusion started and whether the confusion
is constant or intermittent.
DIF: Cognitive Level: Application REF: p. 206 OBJ: 6
TOP: Assessing Confusion KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity
6. The family of a patient with dementia expresses concern to the nurse about the patient
wandering at night. They are afraid that the patient might get up while they are
sleeping and go outside. What is the best advice for the nurse to provide?
a. Apply a vest restraint at night.
b. Perform constant reality
orientation.
c. Learn some behavior modification
techniques.
d. Put new locks on the outside doors
in new places.
ANS: D
Take advantage of the fact that patients with dementia are usually unable to learn new
things. They will probably not be able to figure out how to work a new lock.
DIF: Cognitive Level: Application REF: p. 211 OBJ: 6
TOP: Dementia Safety KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control
7. A nurse is planning for the nutritional needs of a patient with Alzheimer disease. What
is the best plan to have the dietary department provide?
a. Pureed diet to be fed with a
syringe
b. Foods that the patient can cut up to
keep busy and not lose interest in
eating
c. Finger foods several times a day
d. High-protein liquid diet
ANS: C
Small, frequent meals are less confusing to patients. Finger foods high in protein and
carbohydrates allow patients to feed themselves more easily.
DIF: Cognitive Level: Comprehension REF: p. 209 OBJ: 6
TOP: Nutritional Needs KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
A+PASS ASSURED
Chapter 13: Delirium and Dementia
MULTIPLE CHOICE
1. The family of a patient with Alzheimer disease asks the nurse, “When will my mother
quit being so confused?” On what information regarding dementia should the nurse base
a response?
a. It is a short-term confusional state
that is typically reversible.
b. It is a state of confusion caused
primarily by medications.
c. It is a state of confusion that
usually begins abruptly and lasts a
short period.
d. It is a syndrome that is chronic and
irreversible.
ANS: D
Alzheimer disease is a type of dementia that is chronic and irreversible. Delirium is a
short-term confusional state that has a sudden onset and is typically reversible.
DIF: Cognitive Level: Knowledge REF: p. 205 OBJ: 2
TOP: Dementia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Basic Care and Comfort
2. A nurse is admitting a patient who has been diagnosed as having confusion. What is the
most important observation that the nurse should make regarding this patient?
a. Eating, drinking, and sleeping
patterns
b. Behavior, orientation, memory,
and sleeping habits
c. Urinary and bowel elimination
habits
d. Talking, walking, and sleeping
patterns
ANS: B
The first step in assessing a confusional state is to observe the patient’s behavior,
orientation, memory, and sleeping habits.
DIF: Cognitive Level: Comprehension REF: p. 206 OBJ: 6
TOP: Confusion Assessment KEY: Nursing Process Step: Assessment
, MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
3. While a nurse is dressing a patient who has dementia as a result of Huntington disease,
the patient states, “I don’t want to wear clothes today” and begins to resist help putting
on
, her clothes. What is the nurse’s most appropriate action?
a. Tell the patient that she must wear
clothes or she cannot see her
family later.
b. Get another nurse to help her force
the patient to get dressed.
c. Talk to the patient about her
family coming this afternoon and
continue to assist the patient gently
with dressing.
d. Let the patient go without clothes
but make her stay in her room.
ANS: C
When patients with dementia resist activities such as bathing or dressing, avoiding
confrontations and diverting their attention elsewhere are best.
DIF: Cognitive Level: Application REF: p. 211 OBJ: 6
TOP: Resisting Care KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
4. What are the adaptations to interventions that the Cognitive Developmental Approach
(CDA) to caring for patients with dementia designed to achieve?
a. Increase cognitive abilities.
b. Adapt environment to patient.
c. Offer a wide variety of choices.
d. Abolish irrational fears.
ANS: B
The CDA adapts implementations based on the patient’s cognitive abilities as they are,
modifies the environment, and offers limited choices.
DIF: Cognitive Level: Knowledge REF: p. 211 OBJ: 6
TOP: Cognitive Developmental Approach
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation
5. A nurse is gathering information from the family of a patient who is
experiencing confusion. What important question should the nurse ask the
family?
a. “Are you sure she is confused?
Maybe she just didn’t hear what
you were saying.”
b. “When did you first think she
might be confused? Tell me
exactly what happened.”
c. “Did something bad happen to her
during her childhood?”
, d. “How can you say she is
confused? She knows who she is.”
ANS: B
Family members may be able to provide helpful information when the patient cannot.
The nurse should ask when the symptoms of confusion started and whether the confusion
is constant or intermittent.
DIF: Cognitive Level: Application REF: p. 206 OBJ: 6
TOP: Assessing Confusion KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity
6. The family of a patient with dementia expresses concern to the nurse about the patient
wandering at night. They are afraid that the patient might get up while they are
sleeping and go outside. What is the best advice for the nurse to provide?
a. Apply a vest restraint at night.
b. Perform constant reality
orientation.
c. Learn some behavior modification
techniques.
d. Put new locks on the outside doors
in new places.
ANS: D
Take advantage of the fact that patients with dementia are usually unable to learn new
things. They will probably not be able to figure out how to work a new lock.
DIF: Cognitive Level: Application REF: p. 211 OBJ: 6
TOP: Dementia Safety KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control
7. A nurse is planning for the nutritional needs of a patient with Alzheimer disease. What
is the best plan to have the dietary department provide?
a. Pureed diet to be fed with a
syringe
b. Foods that the patient can cut up to
keep busy and not lose interest in
eating
c. Finger foods several times a day
d. High-protein liquid diet
ANS: C
Small, frequent meals are less confusing to patients. Finger foods high in protein and
carbohydrates allow patients to feed themselves more easily.
DIF: Cognitive Level: Comprehension REF: p. 209 OBJ: 6
TOP: Nutritional Needs KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
